#138 Inflammatory Bowel Disease: Crohn’s and Ulcerative Colitis
Published February 4, 2019
88 min
    Add to queue
    Copy URL
    Show notes

    Learn expert tips for the diagnosis and management of inflammatory bowel disease (IBD) from Dr. Adam Ehrlich, Assistant Professor of Medicine and co-director of the Inflammatory Bowel Disease Program at Temple University Hospital.  In this episode, we learn about the initial work-up, general principles of management, and important primary care considerations for Crohn’s disease and ulcerative colitis (ie endoscopic surveillance, immunizations, bone health/osteoporosis, and more!).

    Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.


    • Written and produced by: Paul Williams MD
    • Edited by: Matthew Watto MD
    • Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
    • Guest: Adam Ehrlich MD


    Check out the ACP's Medical Knowledge Self Assessment Program, MKSAP 18.


    Time Stamps

    • 00:00 Sponsor: MKSAP 18
    • 00:32 Disclaimer, Intro, guest bio
    • 04:05 Guest one-liner, Adam’s movie rec - RBG (documentary), career advice, Paul’s movie rec - Edge of Tomorrow
    • 09:25 Sponsor: ACP’s MKSAP 18
    • 11:25 Definitions and pathophysiology of inflammatory bowel disease (IBD)

    Ulcerative Colitis

    • 13:40 A case of ulcerative colitis; Classic symptoms; Initial approach and basic differential diagnosis
    • 19:10 Smoking and ulcerative colitis
    • 21:17 Initial workup for suspected IBD; Fecal calprotectin
    • 25:50 A bit more on CRP and IBD
    • 26:55 When to refer for colonoscopy
    • 27:58 Back to the case; a typical colonoscopy reports in ulcerative colitis (UC)
    • 30:33 Extraintestinal manifestations of UC
    • 34:50 Initial counseling for newly diagnosed IBD; natural history of IBD, prognosis
    • 39:50 Treatment of ulcerative colitis
    • 43:02 Some specifics on steroids, plus topical therapies

    Crohn’s disease

    • 47:05 A case of Crohn’s disease; initial approach and differential diagnosis
    • 50:25 Initial diagnostic testing; colonoscopy findings in Crohn’s; IBD trivia
    • 53:58 Treatment of Crohn’s disease
    • 58:26 Specifics about biologic therapy for IBD; Endpoints
    • 62:25 Steroid sparing agents, immunomodulators like azathioprine, 6-mercaptopurine
    • 64:48 Can drug therapy be stopped or tapered in IBD?
    • 66:50 Prognosis in Crohn’s and initial patient counseling

    Primary Care considerations

    • 68:35 Surveillance endoscopy,
    • 71:47 Do diet and lifestyle changes for IBD work? What about pregnancy?
    • 76:31 Immunizations
    • 79:25 Bone health, osteoporosis and IBD, screening for iron and nutritional deficiencies
    • 82:27 Take home points
    • 86:28 Outro
        0:00:00 / 0:00:00